Assessing the learning curve of robot-assisted total mesorectal excision: a multicenter study considering procedural safety, pathological safety, and efficiency

• DOI: 10.1007/s00384-022-04303-7
• Publication Date: 2023-01-11T07:03:18Z
• Authors: T. A. Burghgraef; D. J. Sikkenk; R. M. P. H. Crolla; M. Fahim; J. Melenhorst; M. El Moumni; G. van der Schelling; A. B. Smits; L. P. S. Stassen; P. M. Verheijen; E. C. J. Consten
• Keywords: CUSUM; Learning curve

Evidence regarding the learning curve of robot-assisted total mesorectal excision is scarce and low quality. Case-mix mostly not taken into account, curves are based on operative time, while preferably clinical outcomes literature-based limits should be used. Therefore, this study aims to assess excision.A retrospective was performed in four Dutch centers. The primary aim safety individual institutional using a RA-CUSUM analysis intraoperative complications, major postoperative compound pathological outcome (positive circumferential margin or incomplete TME specimen). for efficiency assessed LC-CUSUM time. Outcomes patients before after were compared.In study, seven participating surgeons excisions 531 patients. Learning did exceed predefined limits. time showed lengths ranging from 12 35 cases. Intraoperative, postoperative, differ between operated during curve.The therefore suggested safe. Using as surrogate efficiency, estimated procedures.